Projection (12 page)

"Frank," Lucas shouted.  "Come here."

I was light-headed.  The buzz of fluorescent lights combine with the constant chant from the Day Room made me want to cover my ears.  When I joined Lucas outside the fourth room on the right, the rest of my strength drained out of me.  I broke into a cold sweat.

A woman was lying naked in four-point restraints atop a soiled bedsheet.  Her head was shaved.  A fresh line of what had to be hundreds of perfectly placed sutures ran from her chin, down her neck, between her breasts, along the line of her abdomen and between her legs.  Her eyes were closed, but she was breathing.  An IV ran into each arm.  A large man in his forties with a hospital identification bracelet on his wrist sat next to the bed holding a clipboard.

"Pulse?" Lucas asked him.

The man didn't answer.

"Gabriel!"  Lucas clapped his hands.  "Her vitals."

"Yes, doctor," the man said in an emotionless baritone.  "Pulse sixty-two.  Pressure ninety over sixty."  His eyes were unblinking, and his pupils, in contrast to Lucas’, were huge.

"Increase the drip."  Lucas glanced at me.  "Gabriel was a health aide before he lost his way."

That reference helped me remember Gabriel's case.  His full name was Gabriel Vernon, and he was awaiting trial for dismembering his gay lover.

Gabriel struggled out of his seat.  He stood at least six foot four and had to weigh 275 pounds.  With shaking hands he adjusted the little plastic clips that controlled the rate of flow of the IVs.  I wondered if his weakness and tremor were side effects of antipsychotic medication.  In high doses the medicines can cause a syndrome that mimics Parkinson's disease.

"She looks rough," Lucas said, "but she'll recover."

"Who is she?"

"You don't know?"

I shook my head.

"Doctor Laura.  Not the famous one."

I didn't catch on.  I guess I didn't want to."

"The one who testified before God that I was psychotic.  A lunatic."

I squinted at her face and finally recognized Laura Elmonte's features.  The walls undulated.  I grabbed hold of the door frame.  "What have you done to her?"

"Incision and drainage."

"Incision and drainage?  Of what?"

"Black bile."

"She was helping you."

"She was helping Satan to me!" he seethed.  "She was stuffed full of Lucifer's lies.  All that gibberish about ‘
alien hand
’ while the dark one snaked up my arm."  He started marching down the hall.

There was nothing for me to do but follow him.  I wondered whether that was what Craig Bishop, Peter Zweig, Gabriel Vernon and the others felt.  Psychotic patients — even psychotic killers — need something or someone to steady them against the chaos in their minds.  Who better than a physician from their own ranks?  I took a deep breath and managed to walk the rest of the corridor staring straight ahead, reminded by low moans and weak cries that a gallery of terrors lay in the rooms to either side of me.  I hadn't sent the two social workers or the dietician on the unit yet.  And I knew from what had happened to Grace Cummings that Lucas’ violence could engulf patients as well as staff.

Lucas stopped in front of the next-to-the-last room on the right.  Two patients — one male and one female — stood at the doorway.  They bowed slightly in deference to him.  Lucas gestured for me to join him inside.  I assumed he meant the room to be mine.  When I reached it, however, I saw a pale, naked man face-down on the bed in four-point restraints.  His head was shaved like Elmonte's and marked with a black upside down V running ear to ear, the point of the V at the back of the crown of his head.  I wondered whether he might be one of the social workers.  Lucas walked to the side of his bed.  "I'll need you to scrub with me for this one," he said, stroking the man's scalp.

The man struggled to move his head away, but Lucas’ fingers stayed with him.

"Lord knows I've tried everything.  Haldol.  Thorazine.  The quiet room.  Even shock therapy."

"Shock therapy," I said, more to myself than to Lucas.

He nodded at the electroconvulsive therapy machine in the corner of the room.  As a medical student I'd been amazed how small the machines were, not much bigger than boom boxes on legs.  I figured out something that throws a man into epileptic fits ought to look ominous — a wall of blackened steel and chrome dials.  "We got seizures of respectable length, too," Lucas said.  "Fifteen seconds or more.  A dozen times.  But he's not responding."

A kind of desperation, a distant cousin to courage and a much closer one to panic, grabbed hold of me.  "What are you trying to help him with?" I asked, taking a step closer.

"Evil, like the rest.  He killed his own son," Lucas said.  "Can you imagine such a thing?  A boy just eight years old.  And he won't pray." for his own salvation."  He leaned next to the man's ear.  "
He refuses to renounce the demons in his skull
."

I took another step toward the two of them.  "Maybe you haven't reached the little boy in him," I said reflexively, a boxer fighting on instinct.

Lucas seemed not to have heard me.  He straightened up but stayed focused on the man's head.  "Luckily I rotated through three months of neurosurgery before I settled on plastics," he said.  "Together you and I will get where we need to go."

"Where is that?" I asked.

"The amygdala."

The amygdale is a tiny structure that looks like an almond buried deep beneath the cerebral hemispheres, near the center of the brain.  Neuroscientists consider it a critical processing center for emotions and behavior, including anger and violence.  "What do you mean, get there?" I asked.

"Surgically.  It must be removed."

I could feel my pulse in my temples.  "You can't..."

"I know I don't have the benefit of CT guidance, or my right hand for that matter," Lucas went on.  "But we'll manage."

"You'll never get at his disease with a scalpel," I said.  "Or Haldol.  Or shock treatments."

Lucas glared at me.

Something inside me drove me past any hint of safety.  Maybe I wanted to absorb Lucas’ rage myself.  I'd done it countless times for my mother, standing in as a punching bag when my father was drunk and swinging.  I'd done it for my patients until my own sanity had started to wear thin.  Or maybe it was the gambler in me, throwing down the truth the way I used to throw down my last couple grand — my mortgage-drug-car-bar money — on a single hand of blackjack, as if the Fates would hesitate to clean me out.  "You can't cut out his disease any more than you can rid yourself of evil by chopping off your arm," I said.

His face flushed and his lip curled.  "You need time to think," he said, barely containing himself.  "We have a job to do here before I can leave."  He turned on his heels.  "Come along."

I followed Lucas across the hall to the last room on the left, next to the quiet room.  He pulled open the door and swept his stump over the threshold.  His lip still quivered with rage.  "Your room, sir."

I looked in.  A bare mattress lay between raised bed rails.  Leather wrist and ankle restraints were buckled to each corner.

"Too bad Rachel's gone," he said, with a twisted grin.  "The two of you could have had quite a time in a place like this."

If I needed a reminder of the malignant character layered beneath Lucas’ insanity, that did the trick.  I remembered the day he had boasted to me about the humiliation he had heaped on women, including Emma Hancock's niece.  And I remembered that he had let Kathy go on killing and killing, until Rachel was dead.

The nearest patient was at least ten feet away.  Against Lucas’ one arm I could easily outmaneuver him into a choke hold.  I could probably snap his neck before any of his Haldol zombies made it over to us.  I was farther from the chanting in the Day Room, but it suddenly echoed louder in my ears.

I have no life.  I have no death.

"I remember watching her dance at the Lynx Club," Lucas went on.  "She had that nice ass.  A very nice little ass."

I fantasized how it would feel to overcome the last of Lucas’ life force with the quick twist that would sever his spinal cord.  I heard — almost felt — his vertebrae cracking against my arm.  Maybe Lieutenant Patterson had been right, maybe that was the best treatment for a beast.  Take Lucas.  Some of what I was feeling must have been in my eyes because he took a step back.  He nearly cowered.  And all of a sudden, and only for an instant, he looked less a monster and more a frightened, disfigured man.  A sick man.  I remembered how Hollander had warned me to inspect my own emotions to make certain they weren't projections from Lucas’ psyche.  And that helped me convince myself, barely, that I was feeling his murderous rage, that I didn't own it unless — until — I acted on it.  To triumph over his madness, I had to refuse madness.  If Satan is anything, he is a master of temptation, a drug pusher selling the potential darkness inside every one of us.

I closed my eyes to keep from seeing the way I could kill him.  "I was wrong to let you stay locked up in prison," I said.  "I wanted to see you suffer.  I didn't know how ill you were already."

I felt a blaze of pain across my left cheek, then a kick to my gut that knocked the wind out of me.  I stumbled back into the room and fell hard to the linoleum floor, gasping for air.

Lucas stood at the door, a scalpel in his hand.  "I am waging a war against the darkest force in the universe," he declared.  "I have lost my own arm to the enemy.  You can be of tremendous help.  You can be a soldier for Almighty God.  But you have to be willing and pure of heart."  He stepped back.  The door swung shut, and the dead bolt slid home.

*            *            *

I lay on my side catching my breath.  A dull ache spread through my gut.  I watched drops of blood from my cheek feed a little pool that had started to form at the border of one green linoleum square.  I blindly traced the length of my wound with my fingertip, guessing it ran about four inches, knowing it ran deep.  I struggled to a kneeling position.  I took in as much air as my pain would allow and used the bed rails to pull myself to my feet.  I walked to the sink and looked in the mirror mounted above it.  I figured I needed about ten, fifteen stitches.  I turned on the faucet and doused my face with cold water, butt the blood kept coming.  I pressed my cheek to my shoulder to tamponade the vessels.  As I did, I heard footsteps outside my door, then Lucas’ voice.

"You're certain that's twenty milligrams," he said.  "Don't underdose.  Never underdose."

"Exactly twenty," Gabriel Vernon answered in his baritone.

Twenty of Haldol would drop a racehorse.

"Get it into him.  Do whatever you need to."

The door swung open.  Gabriel Vernon stepped into the room.  He was so broad that the entire door frame disappeared behind him.  I immediately looked for a syringe in his hand, but saw that he was holding a tiny paper cup.  "Medicine for you," he said flatly.  His sunken eyes were unblinking.  "Take it."  He walked within a couple of feet of me and held out the cup.

I looked and saw an orange liquid.  I had hoped for pills.  Pills can be ‘cheeked,’ then spit out.  I'd written my share of ‘mouth check’ orders on violent inpatients who could stash four, five different medicines with the flick of a tongue.

"Take it," Vernon repeated.

I knew if I didn't drink it, he'd force me to.  Or he'd come back with an injection.  But, even so, I didn't reach for the cup.  Twenty milligrams of Haldol wasn't a lethal dose, but it would put me out, probably through the entire day and night.  And anything could happen in that long a time.

"Please.  You got to take it.  I got to make you take it."

Did he not want to hurt me, I wondered?  Or didn't he want to be bothered with the hassle of hurting me?  I reached for the cup.  He handed it to me carefully.  I brought the cup to my lips and sipped the liquid.  A sickly sweet orange flavoring almost covered up the bitterness.  I'd tasted that combination of fruit and chemical before.  It wasn't Haldol.  It was methadone, the opiate used to get people off heroin.  I'd stolen a few sips from the Atlantic Hospital inpatient unit once when I was out of cocaine and out of cash and needed to settle my nerves.  Suddenly, Lucas’ tiny pupils made sense to me; methadone causes pupils to constrict.  I looked at the orange liquid and shook my head.  The road back from addiction had been the toughest journey of my life.

Vernon started toward me, his hands outstretched.  As his fingers closed around my shoulders I fired down the twenty milligrams.  He stopped, took a couple steps back and watched me.  I felt the liquid coat my throat, then warm my stomach.  The enemy was inside.  "You take this poison yourself, Gabriel?" I asked.

"It's medicine."  He studied me.  "I took mine before you took yours."

That probably explained why his hands had been trembling minutes ago, but no longer.  He'd been withdrawing and needed a dose.  I noticed that his pupils had shrunk down to nothing.  "Who gives it to you?"

"The doctor."

It is psychologically impossible to become addicted to methadone in twenty-four hours.  Somehow the patients had gotten access to the drug before taking over the unit.  "How long have you been on it?  Is everyone here using it?"

He took a few steps back.  "Case conference in two hours," he said.  "In the Day Room."  He turned and walked out.

I sat down on the bed.  I was starting to feel light-headed.  I'd swallowed as much methadone as a thirty-bags-a-day addict — a serious junkie — would need to steady himself.  Without a habit, the opiate receptors in my brain were wide-open territory and would be deluged in minutes.  I fell back onto the mattress.  My heart told me I should have fought against Vernon, that being beaten into using a drug would somehow have vaccinated me against falling in love with it.  Regret welled up in me for an instant, then was gone.  Opiates are like grease for the superego.  They keep you rolling through the times and places in your life where conscience should slow you down or grind you to a halt.  Psychic pain, that gift from God that can warn us we are lost, is quelled.  I closed my eyes.  Even more quickly than I guessed it would, my body seemed to get heavy, sinking deeper into the mattress.  My mind grew lighter than air.  And not unpleasantly, the two parted company.